Зміни активності А-амілази ротової рідини в процесі комплексного лікування хворих на ішемічну хворобу серця з дефектами зубних рядів

Abstract

У роботі представлені результати дослідження активності а-мілазив нестимульованій ротовій рідині хворих на ІХС із дефектами зубних рядів до і після комплексного лікування. За результатами дослідження було виявлено, що амілолітична активність вірогідно знижується на 87,4% у хворих на ІХС долікування. Та в наслідок комплексного лікування активність а-амілази у ротовій рідині підвищилася на 15,53% у порівнянні з основною групою до лікування.

There was indicated that disorders of regional circulation and microcirculation are significant in violation of oral homeostasis. The main indicators displaying the functioning of the mouth as biological system are enzymes and indexes of immune system. It is the main cause of our decision to analyze amylase activity in unstimulated oral fluid during the progress of disease before and after restoration of teeth alignment defects with removable dentures. Materials and methods. There were processed over 37 medical notes of dental patients were treated at clinic of Prosthetic Dentistry and Implantology HSEIU "UMSA for 2014-2015 years period. The main group consisted of 19 patients (had extra diagnosis of coronary artery disease). Examined patients received complex treatment: prosthetics treatment of dental defects with dentures (partial dentures are used) and endovascular combined with traditional treatment (75 mg clopidogrel + 100 mg aspirin per day) and local, including both Ringer's solution, toothpaste "Parodontax" and mouthrinse "Corsodyl." The control group consisted of 17 patients got orthopedic treatment only. Results and discussion. Activity of amylase in oral fluid over the control group is within the normal quantity is 2156,35 ± 146,65 U/ L. Amylase activity in oral fluid, before treatment, among control patients group with coronary heart disease reached 54,23 ± 4,66 U/ L (p≤0,05). It may be caused by involving secretory cells of salivary gland, as the result of bad circulation which occurs in condition of coronary heart disease and affects every vessel. As a result, such abnormalities shift Ph into the acid side and reduce the activity of amylase, as it is known, activity of amylase shows at neutral or slightly alkaline values of Ph. To enhance homeostasis within the mouth we offer therapeutic activities related both to the use of drugs for the treatment of somatic pathology, and local means causing changes in biochemical parameters in the oral fluid indicating the normalization of basic conditions. After analyzing the results of complex treatment, we discovered improvements in amylase activity in oral fluid 334,80 ± 63,87 (U/L). Conclusion: There is possible decrease of a-amylase activity in oral fluid of patients with coronary heart disease before treatment, an average of 2102,12 ± 141,99 U/ L (p≤0,05), it is 2.51% comparing to the control group. Complex treatment with topical therapy significantly improves the oral tissues conditions, secretory function of salivary glands and especially enzymes. Amylase activity increased by 334,793 ± 63,866 U/ L (p≤0,05) – 18.04% comparing to control group. After complex treatment, activity of a-amylase in oral fluid increased by 15.53% comparing to the main group before treatment.